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FLEMING ISLAND SURGERY CENTER, LLC - Florida Company Profile

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Company Details

Entity Name: FLEMING ISLAND SURGERY CENTER, LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Active
Date Filed: 05 May 2005 (20 years ago)
Last Event: REINSTATEMENT
Event Date Filed: 21 Oct 2022 (3 years ago)
Document Number: L05000044741
FEI/EIN Number 202874196
Address: 1670-B EAGLE HARBOR PARKWAY, ORANGE PARK, FL, 32003
Mail Address: 1670-B EAGLE HARBOR PARKWAY, ORANGE PARK, FL, 32003
ZIP code: 32003
City: Fleming Island
County: Clay
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
Downer, M.D. Donald M Manager 1670-B EAGLE HARBOR PARKWAY, ORANGE PARK, FL, 32003
Shah, M.D. Arjav T President 1670-B EAGLE HARBOR PARKWAY, ORANGE PARK, FL, 32003
Pecoraro, M.D. Russell A Manager 1670-B EAGLE HARBOR PARKWAY, ORANGE PARK, FL, 32003
Levine Lawrence M Manager 1670-B EAGLE HARBOR PARKWAY, ORANGE PARK, FL, 32003
Wallace, M.D. William A Manager 1670-B EAGLE HARBOR PARKWAY, ORANGE PARK, FL, 32003
Shah, M.D. Arjav T Agent 1670-B EAGLE HARBOR PARKWAY, ORANGE PARK, FL, 32003

National Provider Identifier

NPI Number:
1457428005

Authorized Person:

Name:
MS. TARA SHEA MCLAUGHLIN
Role:
DIRECTOR OF CONTRACTING
Phone:

Taxonomy:

Selected Taxonomy:
261QA1903X - Ambulatory Surgical Clinic/Center
Is Primary:
Yes

Contacts:

Fax:
9042157960

Form 5500 Series

Employer Identification Number (EIN):
202874196
Plan Year:
2024
Number Of Participants:
65
Sponsors Telephone Number:
Plan Year:
2023
Number Of Participants:
55
Sponsors Telephone Number:

Events

Event Type Filed Date Value Description
REGISTERED AGENT NAME CHANGED 2022-10-21 Shah, M.D., Arjav T. -
REINSTATEMENT 2022-10-21 - -
ADMIN DISSOLUTION FOR ANNUAL REPORT 2022-09-23 - -
LC AMENDMENT 2015-03-24 - -
CHANGE OF PRINCIPAL ADDRESS 2007-05-03 1670-B EAGLE HARBOR PARKWAY, ORANGE PARK, FL 32003 -
CHANGE OF MAILING ADDRESS 2007-05-03 1670-B EAGLE HARBOR PARKWAY, ORANGE PARK, FL 32003 -
REGISTERED AGENT ADDRESS CHANGED 2007-05-03 1670-B EAGLE HARBOR PARKWAY, ORANGE PARK, FL 32003 -

Documents

Name Date
ANNUAL REPORT 2024-05-01
ANNUAL REPORT 2023-03-20
REINSTATEMENT 2022-10-21
ANNUAL REPORT 2021-02-08
ANNUAL REPORT 2020-04-06
ANNUAL REPORT 2019-04-16
ANNUAL REPORT 2018-04-30
ANNUAL REPORT 2017-04-26
ANNUAL REPORT 2016-03-30
ANNUAL REPORT 2015-04-07

USAspending Awards / Financial Assistance

Date:
2020-06-04
Awarding Agency Name:
Small Business Administration
Transaction Description:
ECONOMIC INJURY DISASTER GRANT
Obligated Amount:
0.00
Face Value Of Loan:
0.00
Total Face Value Of Loan:
0.00
Date:
2020-04-19
Awarding Agency Name:
Small Business Administration
Transaction Description:
ECONOMIC INJURY DISASTER GRANT
Obligated Amount:
0.00
Face Value Of Loan:
0.00
Total Face Value Of Loan:
0.00

OSHA's Inspections within Industry

Inspection Summary

Date:
2014-01-21
Type:
Planned
Address:
1670 EAGLE HARBOR PKWY. SUITE B, ORANGE PARK, FL, 32003
Safety Health:
Health
Scope:
Complete

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Date of last update: 01 Aug 2025

Sources: Florida Department of State